Provides administration and department support for care management and clinical teams. Coordinates services and performs administrative functions. Assists in completing activities related to various cross functional projects in support of departmental goals.
DEPARTMENT: PHS-Case Management
REPORTS TO: Supervisor, SMI
LOCATION: Polk or Highlands County
TRAINING SCHEDULE: Monday - Friday, 8am - 5pm for approx. 4 weeks.
WORK SCHEDULE: Monday - Friday, 8:00am - 5:00 pm.
Responds to phones as assigned or team coverage as directed by Supervisor.
Provides technical and administrative support to clinical and behavioral staff as needed.
Assists, completes and submits special projects, reports or assignments to meet department needs and objectives.
Serves as a liaison in corresponding and communicating with providers, vendors and WellCare contacts and/or members representative’s.
Produces, formats and edits correspondence and documents.
Organizes a variety of administrative and clinical tasks and prioritizes in order of importance and impact on members and providers.
Interacts with other departments including Claims, Intake, Enrollment and Member Services to resolve member and provider issues.
Participates and supports tasks, including but not limited to: faxes, discharge preparations, request and/or collection of clinical information, engaging/contacting providers and creation of authorizations if necessary.
Performs other duties as assigned.
Requires traveling to member's home, doctor office, and facilities. Reliable transportation is required with a valid driver license.
Required A High School or GED
Preferred An Associate's Degree in a related field
Required 3+ years of experience in a managed care setting, medical office or facility setting with demonstration of medical administration duties
Required Other In Behavioral Health, 3 years in performing administrative and/or clinical responsibilities in a medical, behavioral, or non-medical setting with demonstration of administrative duties (clerical, admin asst)
Intermediate Knowledge of medical terminology and/or experience with CPT and ICD-9 coding
Intermediate Demonstrated interpersonal/verbal communication skills
Intermediate Demonstrated written communication skills
Intermediate Ability to effectively present information and respond to questions from peers and management
Intermediate Ability to multi-task
Intermediate Other Work effectively within group to achieve desired outcomes
Licenses and Certifications: A license in one of the following is required:
Required Intermediate Microsoft Outlook Proficient in Microsoft Office such as Outlook, Word and Excel